It’s Our Responsibility: Addressing Community and Public Health

Publication

by Charity Shumway

Community and public health research is taking place across Adelphi, from schools where you might expect it, such as the School of Social Work and the School of Nursing, to schools where you might not, such as the School of Business. Here, a glimpse at some of the studies that are leading to a healthier future for us all.

Shelter from the Storm: Hope for Abused Mexican Immigrant Women

The experience of domestic violence can be isolating, but for immigrant women, it can be even more so. Abusers often exploit vulnerabilities like language barriers and lack of transportation to further control their victims. How, then, do women find help? Over the past two years, Adelphi University School of Social Work Assistant Professor Stavroula Kyriakakis, who studies domestic violence interventions for Latina women, has been looking closely at the experience of Mexican immigrant women in the U.S.

The 28 participants in Dr. Kyriakakis’s study arrived in the U.S. after the age of 16, had experienced domestic abuse sometime in the last 12 months, and lived in either New York City or St. Louis. In addition to her qualitative interviews with the participants, Dr. Kyriakakis interviewed social services providers, religious leaders, mental health workers, and legal and social workers.

“Two important findings emerged,” says Dr. Kyriakakis. First, the women often sought clandestine help from other Mexican or Latina women. “They sought out women they thought might have also experienced abuse, often single mothers, and they might get information that way,” Dr. Kyriakakis says. Next, even the most isolated women were going to church and were accessing healthcare services, either for themselves or their children. They were often reluctant to disclose abuse or ask for help in these settings, but both were potential points of intervention.

For Dr. Kyriakakis, these findings can translate directly to action. “The fact that women are already reaching out to other women speaks to the importance of survivor outreach programs and the need for organizations to have them,” she says. And what about churches and healthcare settings where women were going? Why weren’t they asking for help there? “Those are two places to do more investigation,” says Dr. Kyriakakis. On the horizon, she sees follow-up studies on the capacity Hispanic ministries might have for domestic violence intervention and on factors that stop Mexican immigrant women from disclosing abuse in healthcare settings.

Great Healthcare Depends on Great Nurses

With healthcare services and access in ever greater demand, effective nursing leadership is more important than ever. A team of researchers from the School of Nursing and the School of Business is taking a closer look at what sort of leadership creates an outstanding nursing team.

“The interdisciplinary approach of the study is exciting. That’s where we think we’ll be headed more and more in the future—many disciplines working together,” says the research team leader, Adelphi School of Nursing Professor Patricia Donohue-Porter. The full research team includes Dr. Donohue-Porter and Dr. Patricia Eckardt from the Adelphi School of Nursing, and Dr. David Prottas and Dr. Joyce Silberstang from the Adelphi School of Business, as well as Dr. K.C. Rondello who has a joint appointment at both schools.

In addition to collaboration between disciplines at Adelphi, the study has been shaped by close collaboration with Winthrop-University Hospital, where nurses will be surveyed. “We went to Winthrop and presented our ideas to their nursing leadership team and nursing managers and asked them for input into the design. They were really part of the development of the study from the beginning, and that’s unique,” says Dr. Donohue-Porter.

The study looks at organizational culture and organizational citizenship behavior through the lens of Leader-Member Exchange Theory, which holds that the quality of the relationship between the manager of the team and the members of the team is of paramount importance. In the coming year, the research team plans to administer surveys to more than 700 nurses and nursing managers at Winthrop, in hopes of seeing the theory born out. But more than just gathering evidence to support Leader-Member Exchange Theory, the research team hopes to identify specific leadership and communication qualities that lead to strong relationships and effective nursing teams, which can then be shared with hospitals and nursing faculties around the country.

America’s Muslim M.D.’s Give Back

Until recently, we knew very little about the demographics and civic involvement of Muslim physicians in the United States. But, thanks to research by Adelphi University School of Social Work Assistant Professor Wahiba Abu-Ras, that’s all changing.

With a two-year, $80,000 grant from the Institute for Social Policy and Understanding—a think tank focused on the American Muslim community—and support from Islamic Medical Association of North America and the Association of Physicians of Pakistani descent of North America, Dr. Abu-Ras gathered qualitative data through face-to-face surveys with 60 Muslim physicians from across the United States as well as quantitative data through surveys of another 531.

Of the estimated 40,000 Muslim physicians in the United States, Dr. Abu-Ras found that approximately a quarter are women. Most were born and educated outside the United States, and most reported having come to this country for professional opportunities and advancement. Many work in suburban and urban areas and serve underserved communities. Most identify with the Sunni sect, and a majority characterize themselves as religious or very religious, a factor which contributed strongly to their career choice. “When we asked them if their religion was a reason they chose their profession, about half said ‘yes,’” says Dr. Abu-Ras.

When it comes to civic involvement, Dr. AbuRas found that a significant number of Muslim doctors send money to their families abroad and many provide in-kind help to their countries of origin, raising money, volunteering knowledge, operating mobile clinics, and donating time to serve in hospitals without pay.

In the United States, their civic involvement is also significant. Dr. Abu-Ras compared the data she gathered on Muslim physicians to data from a 2007 study of the political activity of U.S. physicians. “I was fascinated to see that Muslim physicians assigned a higher role to their civic involvement than the general population of U.S. physicians,” says Dr. Abu-Ras. What’s more, says Dr. Abu-Ras, Muslim physicians reported becoming more civically involved after 9/11.

Auditing the Healthcare of Black Families

How clear are pharmaceutical directions, really? Take three times a day seems straightforward, but those directions don’t necessarily mean the same thing to everyone. Take how? And when, exactly? The gap between how doctors and patients understand prescription drug instructions was just one of the barriers to improved maternal and child health identified by Adelphi University Gordon F. Derner Institute of Advanced Psychological Studies Associate Professor Carolyn Springer in her five-year study on black family health.

With the help of a $200,000 grant from the Health Resources and Services Administration’s Maternal Child Health Bureau, Dr. Springer and her research team, which included Adelphi master’s and undergraduate psychology students, conducted focus groups with 77 black families in cities around the country. Her research divided patients into three types of focus groups: men, pregnant women, and co-ed groups. In addition to her findings that gaps in communication exist between patients and healthcare providers, particularly when it comes to prescription drugs, each type of focus group shed light on particular challenges black families face in accessing healthcare.

The pregnant women’s focus groups highlighted the fact that in some states, women are only able to access affordable care if they’re pregnant, a significant barrier to ongoing care. A theme among the men’s groups was the assumption that black men are absentee fathers and the resulting inadequate inclusion of men in family healthcare settings. Says Dr. Springer, “Some men told us stories where they were primary caregivers and were treated with surprise and as if they shouldn’t be there. That creates obstacles and can prevent men from playing a full role even if they want to.” In all the groups, says Dr. Springer, many participants talked about differences in the quality of care and the type of treatment afforded those with private insurance versus public types of insurance. “Many talked about having insurance, but not enough coverage. People delay seeking care for worry about cost,” says Dr. Springer.

Now that Dr. Springer has concluded her research, she is working to disseminate her findings, both through scholarly publications and presentations and through outreach to healthcare consumers and healthcare providers. In addition to identifying problems, her research identified many solutions, says Dr. Springer. “Things like checklists for patients to go through and prepare before their visits can be helpful. Friendlier, warmer medical settings, staff who can meet with patients to make sure they understand everything before they leave the office, and advocates or liaisons from the community who can follow up with patients can also make a difference. We’re using all our findings to develop tools for families.”